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dc.contributor.authorSood, Siddharth-
dc.contributor.authorHaifer, C-
dc.contributor.authorYu, L-
dc.contributor.authorPavlovic, J-
dc.contributor.authorGow, Paul J-
dc.contributor.authorJones, Robert M-
dc.contributor.authorVisvanathan, Kumar-
dc.contributor.authorAngus, Peter W-
dc.contributor.authorTestro, Adam G-
dc.identifier.citationTransplant Infectious Disease : an Official Journal of the Transplantation Society 2018; 20(5): e12934en_US
dc.description.abstractAlthough antiviral prophylaxis is effective in preventing early cytomegalovirus (CMV) reactivation following liver transplantation (OLT), it predisposes patients to late CMV after prophylaxis has ceased. QuantiFERON-CMV (QFN-CMV, Qiagen, The Netherlands) measures an individual's viral-specific immune response. Fifty-nine OLT recipients were prospectively monitored post-OLT in an observational cohort study. QFN-CMV was performed at regular time-points. An absolute QFN-CMV <0.1 IU/mL was considered non-reactive. 50/59 (84.7%) had a reactive QFN-CMV by M6. 38/59 (64.4%) had antiviral prophylaxis or treatment before M6, with 31/38 (81.6%) developing a reactive QFN-CMV by 6 months. Over 90% already had a reactive result as early as 3 months post transplant, 3 patients (5.08%) developed late CMV between 6-12 months (median 251 days)-all had a non-reactive M6 QFN-CMV. And 2/3 experienced CMV disease. Non-reactive M6 QFN-CMV was significantly associated with late CMV (OR = 54.4, PPV = 0.33, NPV = 1.00, P = .003). Although only 5% of recipients developed late CMV, 2/3 suffered CMV disease. M6 QFN-CMV has an excellent NPV for late CMV, suggesting patients who exhibit a robust ex vivo immune response at M6 can safely cease CMV monitoring. Furthermore, >90% already express viral-specific immunity as early as 3 months. Conceivably, antiviral prophylaxis could be discontinued early in these patients.en_US
dc.subjectCMV diseaseen_US
dc.subjectlate CMVen_US
dc.subjectliver transplantationen_US
dc.titleEarly viral-specific T-cell testing predicts late cytomegalovirus reactivation following liver transplantation.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleTransplant Infectious Disease : an Official Journal of the Transplantation Societyen_US
dc.identifier.affiliationVictorian Liver Transplant Uniten_US
dc.identifier.affiliationDepartment of Gastroenterology & Hepatology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationInnate Immune Laboratory, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australiaen_US
dc.type.austinJournal Article-, Peter W
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.languageiso639-1en- Liver Transplant Unit- Liver Transplant Unit- Liver Transplant Unit- and Hepatology- Liver Transplant Unit- (University of Melbourne)- Surgery- and Hepatology- Liver Transplant Unit- and Hepatology- Liver Transplant Unit- and Hepatology-
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